Provider Demographics
NPI:1275310948
Name:I CARE HOME HEALTH & MENTAL WELLNESS LLC
Entity Type:Organization
Organization Name:I CARE HOME HEALTH & MENTAL WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C EO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLETT
Authorized Official - Middle Name:LATRICE
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-413-8831
Mailing Address - Street 1:11743 NORTHPOINTE BLVD APT 115
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-5575
Mailing Address - Country:US
Mailing Address - Phone:832-413-8831
Mailing Address - Fax:
Practice Address - Street 1:11743 NORTHPOINTE BLVD APT 115
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-5575
Practice Address - Country:US
Practice Address - Phone:832-413-8831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community Based
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care